Rest or Activity, Which Heals Fastest?

When I graduated and began my chiropractic practice in 1973, the common thinking was that an injury, particularly an acute one, required much rest. After a whiplash injury, the use of a cervical collar was standard. Although I have never prescribed one, the sight of a hard-sided collar was common. Four weeks of bed rest following a lower back injury was the medical norm. Ten-day hospital stays were expected, even after minor surgeries. All this has changed, partly due to economics, but mainly due to research and common sense.

It made no sense to me to rest so much. In those days you could go to any hospital and ask almost any patient what his or her main complaint was, and regardless of what condition they were being treated for, most would say what hurt was the spine. Excessive bed rest creates havoc in the neck and lower back. The old adage, ‘use it or lose it’ comes into play real fast here. The spine is meant for activity and locomotion and very rapidly stiffens up with immobilization. Research has since shown that bed rest past 4 days doesn't help and only leads to increasing chronicity. The use of a cervical collar for more than 3 days for neck strain and you are just asking for trouble later on. There have been lots of studies into these areas; however, medicine loves to study things so why not continue the trend to prove again what is now conventional wisdom in chiropractic circles.

I honestly believe that researchers in medicine study ad infinitum and state the obvious so often due to the fact that in the area musculoskeletal injuries the average GP has no real clue what to do. The plan seems to be to prescribe rest, NSAIDs and hope the case is self-limiting. Even though study after study has shown this to be the wrong approach in most cases, the message just isn’t getting through.

Lately, there has been a trend to think that if they added reassurance and education in the form of a self-help booklet to the above ‘treatment protocol’ then MD’s would really have something. Recently, there was a much-touted study that ‘proved’ that reassurance and an education booklet worked as well as ‘chiropractic’(1). The problem was that the researchers didn’t bother to find any real chiropractors to take part in the study. Instead, they very scientifically trained a group of MD’s over a weekend to do what they laughingly called ‘chiropractic’. Once sufficiently ‘trained’, the study began. Was it any wonder that the self-help books were as effective? With these clowns floundering about on unsuspecting peoples’ spines, it is a wonder that anyone hung around long enough to finish the course of ‘treatments’. I often wonder why our profession does not sue the authors of the study for libel, except we have our hands full currently with a huge lawsuit in the US over discriminatory practices of some major health insurance providers.

Go To Page: 1 2

Articles in this Topic    Discussions in this Topic